<style>
.bootstrap-select{
    width: 49%!important;
    display: inline-block!important;
}
#selectpage_user{
    width: 50%!important;
    display: inline-block!important;
}
</style>

<form id="sendmb-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">消息类型:</label>
        <div class="col-xs-12 col-sm-8">
           <select  id="c-typeid" data-rule="required" class="form-control selectpicker" name="row[typeid]">
                {foreach name="TypeList" item="vo"}
                <option value="{$key}" {in name="key" value="yimiao"}selected{/in}>{$vo}</option>
                {/foreach}
            </select>
        </div>
    </div>
    <div id="show_yimiao">
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">接种地点:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-message_address" class="form-control" name="row[message_address]" type="text" placeholder="例如：**卫生院">
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">提示说明:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-message_yimiao_content" class="form-control" name="row[message_yimiao_content]" type="text" placeholder="例如：若有不良反映，需及时联系接种服务单位">
            </div>
        </div>
    </div>
    <div id="show_putong">
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">提醒内容:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-message_title" class="form-control" name="row[message_title]" type="text" placeholder="例如：晚上可以加一粒">
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">提示说明:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-message_content" class="form-control" name="row[message_content]" type="text" placeholder="例如：您可以在微信中直接回复医生">
            </div>
        </div>
    </div>

    <div id="show_jiuzhen">
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">就诊人:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-username" class="form-control" name="row[username]" type="text" placeholder="例如：张三">
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">就诊科室:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-keshi" class="form-control" name="row[keshi]" type="text" placeholder="例如：骨科">
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">就诊医院:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-hospital" class="form-control" name="row[hospital]" type="text" placeholder="例如：人民医院">
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">就诊时间:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-date" class="form-control" name="row[date]" type="datetime" placeholder="例如：2025-09-18">
            </div>
        </div>
        <div class="form-group">
            <label class="control-label col-xs-12 col-sm-2">提示说明:</label>
            <div class="col-xs-12 col-sm-8">
                <input id="c-content" class="form-control" name="row[content]" type="text" placeholder="例如：请您按时前往医院完成挂号就诊。">
            </div>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
